作者：Amanda Oakley Fracp，皮肤科医生，新西兰汉密尔顿，2011年。由澳大利亚悉尼的妇科医生詹妮弗·布拉德福德博士进行了审查。
Painful sex is also calleddyspareunia. Dyspareunia is defined aspersistent或者recurrentgenitalpain that occurs just before, during or after intercourse. There are two types of dyspareunia in women:
全疾病困难is common and may cause considerable distress to women and their sexual partners. It may be caused by structural, infective andinflammatorydiseases of thevulva, vagina and internal organs.社会心理因素inevitably contribute to and result from, dyspareunia.
全疾病困难associated with a dry vagina or阴道l炎(阴道炎) may be due to:
正确的诊断需要对整个身体进行仔细的病史和临床检查，包括外部生殖器，以及医学专家（例如妇科医生，性健康医师或全科医生）或物理治疗师的骨盆检查。Colposcopy可以执行（这是使用放大倍率和明亮光的骨盆检查）。应仔细识别疼痛部位。检查下anaestheticmay be required if discomfort is too great to allow a normal internal examination.
Investigations may include:
Intercourse should not be painful. It's important to feel relaxed before attempting intercourse. Foreplay leading to sexual excitement relaxes the pelvic muscles, widens the vagina and releases vaginal fluids. Use liberal amounts of water-based lubricants and apply these to the penis and vaginal opening. Penetration from behind or woman-on-top may be better tolerated.
If a cause for the dyspareunia has been found, appropriate treatment should help.
An experienced pelvic floor physiotherapist can help in retraining the pelvic floor to relax using special exercises. Counselling or behavioural therapy is appropriate for some women or couples.
If vaginal intercourse remains painful, consider other sexual options including massage and mutual masturbation.
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